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Finger Joint Arthritis

picture of PIP joint finger arthritisArthritis can appear anywhere in your finger. Osteoarthritis is the most common type of arthritis that affects the middle joint of the finger, also called the proximal interphalangeal joint. I’ll show you where this joint is in your finger and what can be done to treat it.


In the following drawing of two finger bones, you can see the normal finger joint in the top picture. It’s wide; there’s a nice, healthy space between the two bones.

normal pip joint drawing

Drawing of a normal PIP joint

This is the PIP (proximal interphalangeal) joint. When I’m referring to it, I say, “P-I-P” (pronounced pee-eye-pee). It just means the joint between the two finger bones closest to the wrist.

What does finger arthritis feel like?

Patients with arthritis feel a deep aching, sometimes a sharp pain in this joint with gripping or heavy use activities.

Some patients feel pain most of the time or even with light activities, like getting ready in the morning or with writing.

How is finger arthritis diagnosed?

Hand surgeons diagnose finger arthritis by examining your hand and taking regular x-rays.

In the following drawing (compare this with the drawing above), I’ve pointed out the complete destruction and narrowing of the joint space between the two bones.

PIP joint arthritis in the finger

Drawing of PIP joint arthritis and joint destruction

 

You can also see the big bone spurs sticking out around the joint – they look like tiny spikes.

What can you do to relieve finger joint arthritis pain?

I recommend a combination of avoiding strenuous activity, anti-inflammatory medications, and heat.

Unfortunately, the more we move our fingers, the more stress and strain we put on them, the faster they wear out, especially once arthritis sets in. Learn what activities make your finger pain worse, and avoid or limit those activities.

Anti-inflammatory medicines (oral or topical) can help decrease swelling, pain, and redness that can go along with arthritis.

Heat (bath, shower, paraffin wax bath, warm washcloth, etc.) will open up capillary blood flow and decrease pain. It also loosens up stiff joints and tendons, helping you move your joints better.

How can a hand specialist help?

Once you’ve tried over the counter medicine and non-invasive treatments without success, it may be appropriate to think about the next step.

Prescription-strength anti-inflammatories may work better than over the counter medication. Your regular doctor or hand specialist can prescribe these. Topical pain creams work better in small finger joints close to the skin better than deeper joints (like the hip).

Steroid (cortisone) injections also help dramatically reduce inflammation and pain in small finger joints. These are usually done in the office. I use local anesthetic to numb up the skin before injecting the steroid.

All these conservative treatments are simply band-aids for the arthritis. They help with symptoms (sometimes for months or years), but never cure it.

Replacing the joint is the only way to preserve motion of the joint and stop finger arthritis pain permanently.

Joint replacements are made from either silicone or metal. The arthritic portion of the joint is cut out, leaving a space. The surgeon then fills this space with the joint replacement implant, usually a piece of soft, flexible silicone.

silicone PIP arthroplasty

Silicone artificial joint in a PIP joint for finger arthritis

Recovery from this surgery is usually about 2 months; you can start gripping and lifting more aggressively at that time. Some therapy is necessary.

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